<!--<?php
print <<<EOT
-->

<script src="../css/edit.js"></script>
<script>
<!--


function validate(form) {
	if(!isEmail(form.dealerinquiryemail.value)) {
		showMsg('msg_area', 'Invalid Email.');
		form.dealerinquiryemail.focus();
		return false;
	}
	
	
	return true;
}

//-->
</script>

<!--Content Start-->
<table width="95%" border="0" align="center">
  <tr> 
    <td>&nbsp;</td>
  </tr>
  <tr> 
    <td>
    
      <form action="c_customer_list.php" method="post" name="form1" onSubmit="return validate(this)">
      <input type="hidden" name="action" value="add">
      <table width="60%" align="left">
    
      <tr><td>
      <table width="95%" border="0" align="center">
        <tr> 
          <td align="right">&nbsp; </td>
        </tr>
        <tr> 
          <td>
            
          <table width="100%">
		                        <tr><td colspan=2><span id="msg_area"></span></td></tr>
		                        
		                        <tr><td colspan=2  height=5></td></tr>
		                        
		                        
		                        <tr class="tdheader">
		                            <td align="right">Company:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquirycompany" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">First Name:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryfirstname" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Last Name:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquirylastname" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Business Type:</td>
		                            <td align="left">
		                            <select name="dealerinquirybusinesstype" class="select">
									  <option value="" selected>---Please Select---</option>
									  <option value="Importer">Importer</option>
									  <option value="Wholesaler">Wholesaler</option>
									  <option value="Retailer">Retailer</option>
									  <option value="Designer">Designer</option>
									</select>
		                            </td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Years In Business:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryyearsinbusiness" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Address:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryaddress" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Address 2:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryaddress2" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">City:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquirycity" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">State/Province:</td>
		                            <td align="left">
		                            <select name="stateid" class="select">
		                              <option value="" selected>---Please Select---</option>
		                              $state_select
		                            </select>
		                          </td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Country:</td>
		                            <td align="left">
		                            <select name="countryid" class="select">
		                              <option value="" selected>---Please Select---</option>
		                              $country_select	
		                            </select>
		                            </td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Zip/Postal Code:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquirypostal" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Phone:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryphone" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Fax:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryfax" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Email:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryemail" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Company Registration Number:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryregistrationnumber" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">URL:</td>
		                            <td align="left"><input type="text" class="text" name="dealerinquiryurl" class="form" size="30"></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Where did you find us:</td>
		                            <td align="left"><textarea class="text" name="find_us_content" cols="66" rows="4"></textarea></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Comments:</td>
		                            <td align="left"><textarea class="text" name="comments" cols="66" rows="4"></textarea></td>
		                        </tr>
		                        <tr class="tdheader">
		                            <td align="right">Info about your company:</td>
		                            <td align="left"><textarea class="text" name="company_content" cols="66" rows="5"></textarea></td>
		                        </tr>		           

		                        <tr><td colspan=2  height=20></td></tr>
		                        
		                        <tr class="tdheader"> 
                                  <td align="right">Type :</td>
                                  <td align="left">
                                    <select class="select" name="typeid">
                                      <option value="0">--Please select--</option>
                                      ' . $type_select . '
                                    </select>
                                  </td>
                                </tr>                    
                                <tr class="tdheader"> 
                                  <td align="right">Status :</td>
                                  <td align="left">
                                    <select class="select" name="statusid">
                                      <option value="0">--Please select--</option>
                                      ' . $status_select . '
                                    </select>
                                  </td>
                                </tr> 
                                <tr><td colspan=2  height=10></td></tr>                         
		                    </table>
		                    
		                    
          </td>
        </tr>
      </table>
     </td></tr>
    
      <tr><td>
      <table width="95%" border="0" align="left">
        <tr> 
          <td align="center">
            <input type="image" src="../images/admin/bt_cancel.gif" width="78" height="23" onclick="location.href='c_customer_list.php'; return false;"> 
            <input type="image" src="../images/admin/bt_save.gif" width="76" height="22" onclick="form1.submit"> 
          </td>
        </tr>
      </table>
      </td></tr>
      </table>
      </form>

      <p>&nbsp;</p></td>
  </tr>
</table>
<!--Content End-->

<!--
EOT;
?>-->